HAPPINESS

Today, we have a blog post from our Osteopath and director David Propert who is sharing some useful insight from his recent experience in the clinic. Important life lessons for all of us.

‘Last week I found myself waiting for a patient to turn up for a first consultation. He had spent time face to face with our receptionist only a few days before, trying to sort out a suitable appointment slot, and now here we were and he hadn’t shown up. This was irritating but, luckily, there was someone on the waiting list who was local and could step into the slot.

When we finally managed to contact the no-show patient he explained that because he hadn’t received an electronic reminder (we normally email or text these in advance as a courtesy), he had forgotten about the appointment.

Whatever happened to self-reliance?

Today a colleague described how she had had a similar experience recently with a patient who hadn’t turned up because he “hadn’t updated his WhatsApp” so didn’t receive the reminder she had sent him via that medium.

These are just two examples of a developing trend that seems to be affecting ourselves and our patient population: Technological Dependency. This is an expression coined, originally, to describe a developing country’s dependency on outside help. Now it can be applied to the increasing rise of anxiety conditions related to a person’s separation from technology and the apparent inability for some individuals to function properly without the use of technology. There is now a specific dictionary term for this: Nomophobia (defined as ‘a state of stress caused by having no access to or being unable to use one’s mobile phone’). This is quite likely to appear in the next edition of the American Psychiatric Association’s DSM as a distinct diagnostic entity and there are already metrics for scoring a person’s mobile phone dependence.

Many authors have written about this phenomenon (see the excellent contributions by Calmer Clinics’ Jennifer Day, as well as Dr. Elias Aboujoade’s book: ‘Virtually You: The Dangers of the E-Personality’, articles in ‘Psychology Today’, and the excellent ‘The Brain That Changes Itself’ by Dr Norman Doidge, not to mention ‘Brave New World’-type prophetic novels forecasting the rise of the machines). They agree that it is akin to an addiction and needs to be addressed as a health concern because it affects mood and behaviour in an ultimately destructive way leading to impatience, impulsiveness, forgetfulness, and narcissism.

Another reminder of our abrogation of responsibility to technology is the ‘sat-nav effect’ whereby an individual drives the wrong way or into an inappropriate, or dangerous situation against their better judgment because the machine is telling them to. We can begin to appreciate the real problem: our own autonomous human judgment is being trumped by technology. Confidence in human intelligence then begins to wane and the tool designed to assist us becomes the substitute brain. The idea that it frees our minds to work on more serious problems is undermined by the fact that nature really does work on a ‘use it or lose it’ basis. Our mind becomes the 3rd -World equivalent relying on 1st-World technology.

And what about issues of self-worth and how we value and respect one another? All too often it is being measured by numbers of ‘followers’ and ‘likes’. In this pseudo-reality, our true sense of self is lost to the cyber universe. Of course, technology can provide huge benefits to individuals as well as to society. Perhaps what we are witnessing is just an adaptation period as we get used to incredible technological advances beyond our immediate capabilities for putting them to good use. Our current technological revolution has been likened to the industrial revolution of the late 18th century, with the new public health problems that were produced as a result of progress.

The Turing test is a benchmark for whether or not a machine can mimic human intelligence to such a degree that it becomes indiscernible from ‘real’ human intelligence. This has provided motivation to produce ever more sophisticated computers but we forget that the linear scale of this measure of machine intelligence has two ends. What if instead of machines becoming cleverer, human beings are becoming dumber? Smartphone – stupid person. How long before ‘AI’ becomes the gold standard and becomes simply ‘I’?

So, if you notice feeling unsettled or anxious when separated from your device or the internet, using it as a substitute for or finding it is getting in the way of social interaction. If you catch yourself switching it on by habit and at inappropriate moments, relying on it to remember, and feeling lost without it:

-Just switch it off! Try spending a whole day without it. Progress to a weekend.

-Consider practices such as mindfulness/ meditation, for learning to be in the moment and developing the discipline of just ‘being’ rather than ‘doing’.

-Never take your phone to bed or to the bathroom!

-Exercise without technology for a change. How ironic that we have to labour in the gym or metaphorical (and literal) treadmill to replace the exercise we are no longer taking naturally as a result of labour-saving devices!

We, at Calmer Clinics, welcome you to discuss these and other issues with our excellent team of health professionals. For more information, check our website for the full list of therapies offered.

Post-Brexit; Austerity winners and losers; Nationalism vs accepting immigration; Black Lives Matter; Corbynistas vs Blairites; U.S. gun control; Trump vs Clinton: There has been plenty of media discussion focused recently on the idea of a divided society. Perhaps this is an oversimplification. Do societies really exist in binary terms; Us and Them? The notion of multiple tribes interacting and working together for the common good is one of the fundamentals of ‘civilised society’. Of course, it is very personal where we place ourselves on the individualism/ socialism spectrum and how are beliefs are shaped, which is why politics and religion are so potentially divisive.

These issues are analysed by sociologists and political scientists, amongst others, but there is also a healthcare implication. The philosopher, Jiddu Krishnamurti (1895-1986) coined the term: ‘The Sick Society’. Having lived through colonisation and two World wars, his comment was certainly informed by personal experience. What he actually said was: “It is no measure of health to be well adjusted to a profoundly sick society”. Perhaps the unease we may be feeling at the moment is, in fact, a perfectly healthy response to a troubling situation. Dis-ease as a response to disease. In the same way, our minds produce the subjective sensation of pain in response to a disturbed state.

We pride ourselves on providing highly individualised healthcare for those seeking our help. There’s the rub (pardon the pun). Evidence-based (with appropriate measures) and socialised medicine can provide data for what might be best for most of the people most of the time but often is not helpful when it comes to determining where the individual patient ‘fits’ into the scheme of things. Describing them as ‘typical’ or ‘atypical’ is, again, divisive, oversimplified and unhealthy. Many of our patients come with presenting symptoms that do not fit into the classic diagnostic boxes and the challenge is to combine the best of generalised accumulated medical knowledge with the detailed history of the individual person.

Within the individual there is again the concept of division. Aristotle and Plato explored the idea of multiple souls but it was René Descartes (1596-1650) who described the dual nature of human existence. Often called mind-body (Cartesian) dualism, it refers to the relationship between the physical (body) and spiritual (mind). Unfortunately, this has often been misrepresented in modern times as if the brain and body are independent entities. The body reflects the mind (and has been described as the graveyard of the emotions) and is the life-support system for it. Neural plasticity determines that there is a self-repairing dynamic equilibrium (termed ‘homeostasis’ by Walter Cannon in 1926) within the mind as there is in all other physiological systems. It is when this breaks down that ill health can occur.

R.D. Laing (1927-1989) was a Psychiatrist whose revolutionary approach separated the lived experiences of the individual patient (suffering from mental illness) from accepted generalised medical diagnoses. In 1960, his seminal work ‘The Divided Self’ was published. In this, he used case studies to show that psychosis is not a medical condition but an outcome of the ‘divided self’ or tension between the two personas within us: one our authentic, private identity, and the other the false ‘sane’ self that we present to the World. Dr Jekyll and Mr Hyde or Yin and Yang? It is interesting to note that the Yin and Yang pictogram, shows there is an element of each in the other.

Previously, Sigmund Freud (1856-1939) and others looked at what were considered to be the ‘animal instincts’ that are suppressed in the ‘civilised’ individual and in ‘civil society’. They looked at the mechanisms by which this suppression occurs, to better understand what happens in individuals and societies where unrest has broken out. The term ‘sublimation’ was borrowed from the writing of Friedrich Nietzsche (1844-1900) and Freud likened it to maturation. So, the mature individual has a moral compass and the mature society has an ethical compass. What happens, however, when the magnetic poles are changed or distorted?

Sick individuals lead to a sick society and vice-versa. Just as Utopia is a mirage, so is the ultimate ‘perfectibility’ of the individual (as described by Jean-Jacques Rousseau (1712-1778) in his study ‘On Education’). We are constantly teetering on the brink as a society and as individuals. Homeostasis is necessary for both.

When considering our health from a holistic perspective – connecting the dots physically, mentally and emotionally – I have found it can be helpful to use an analogy. Last summer, I came across one that struck me as quite clever, in a book called The Happiness Hypothosis (by Jonathan Haidt). Encountering it again in another book (Switch by Chip & Dan Heath), my esteem increased by several notches from ‘that’s clever’ to ‘that’s bloomin’ brilliant!’

Imagine emotions represented by an elephant (yes, you read it right). Then imagine thought, or the brain, represented by the rider of that elephant. Finally, imagine the environment they are in, (the people and surroundings they interact with, the destination they are headed for), etc, represented by a pathway. For any journey taken by the elephant and the rider to run smoothly, the pathway needs to be obvious and clear, not cluttered by too much junk, preferably wide enough, and otherwise conducive to the journey and the safe arrival at their chosen destination.

While the idea of a path needing to be clear and conducive may be an analogy you are already familiar with, the concept that is more unusual here is the one that uses an elephant to symbolize emotions, while ‘rational thought’ is represented by a mere man – (when I use the word ‘mere’ I am of course referring to the comparative size). In this context size does matter, because it indicates power and force and, as we know, (even if we rarely take it into consideration on a daily basis), emotions are more powerful than thoughts. In fact, emotions are so much more powerful than thoughts that the ratio is probably quite accurately depicted in this image! Keep going with the analogy and it may look something like this:

When the elephant is well fed & watered (emotionally content), looked after (acknowledged), and cared for (validated), he is happy to oblige the will of his rider’s commands (logical reasoning) and go where his rider tells him to go. However, if he has been deprived of food & water (feelings ignored or denied), has been neglected (invalidated) and kept confined (suppressed), he will not be in any condition to obey his master well. If the rider attempts to force compliance, the elephant will in all likelihood become resentful, uncooperative, defiant, and eventually veer out of control (frustration, anger, or other unpleasant emotion). No matter how much the rider holds the reins and may look like he’s in charge, in reality he is immobilized simply because the six-ton elephant is the larger, more powerful one. Imagine trying to reach your destination in this scenario!

Translate all this back to your own day-to-day environment, thoughts, and emotions, and you may get some insights into why your life isn’t always happening the way you want or think it should! For example; do you ever find yourself escaping into your laptop or I-phone during meetings when you know you shouldn’t be? Or not speaking up when you know you should? Do you ever hear yourself saying something you know isn’t wise or that you’ll regret, but you can’t stop yourself? Or loosing your temper and yelling at your child when you know it’s inappropriate?? Do you know you shouldn’t be eating that cholesterol-packed meal but you just can’t help it? Do you want to be exercising/meditating/practicing self-care but can’t seem to get around to it? I could go on and on with examples of procrastination, flared tempers, avoidance, stressed out behaviours, and – well, you get the picture!

The piece that can be helpful here is the image of your emotions as the six-ton elephant, and your ‘sensible brain’ as the rein-holding rider. When your ‘rider’ wants you to stop (or start) doing something but you don’t ‘agree’, it’s because your ‘elephant’ is not being addressed and so he has taken charge – whether that means he’s charging off, refusing to move or just being inert. Picture the last time this happened to you!……………………………………………………………………………………………………………………………………………………………

Now picture the good news; that when your rider considers the elephant and the two work together, the arrival at your destination (what you want to achieve or how you’d like to behave) is pretty much assured, and you can use the heightened intelligence you gain from all your brain’s systems being coherent, to ensure that the pathway – your environment and conditions – are as supportive as possible.

So next time you feel yourself not being congruent in thought and deed, or in feeling and expression, give yourself a brief ‘time-out’, stop what you’re doing for just one minute, (if you can, stand up firmly on both feet), and take a deep breath. Hold it and notice any tension you are feeling anywhere in your body. Try to identify what it feels like. Then as you exhale, let all the tension go, imagining it melting away from your body the way ice melts in the sun. Now take another breath in and move your attention to your heart. Smile. As you exhale, feel a good ‘smiling’ feeling fill your heart and chest and radiating out to fill your torso. Hold onto and enjoy the good feeling. Now ask yourself what emotions you may have been feeling that interfered with your internal coherence – what was going on with your ‘elephant’?

Or was there something going on with your ‘rider’, like over-analysis, or over-thinking – in which case the ‘elephant’ may have a touch of emotional insecurity going on.

Whatever comes to you, however brief an insight, write it down.

If appropriate, act on it.

This whole process will normally take 2 to 3 minutes, but can often save you hours, even weeks, with the increased coherence between ‘elephant’ and ‘rider’ that you gain!

In my experience, there really is nothing like this kind of development of emotional intelligence; or what we call emotional mastery, to get the ‘elephant’ and the ‘rider’ working together ….. maybe we should re-name it Elephant Mastery.

Occasionally, a patient will present to the clinic with a myriad of health complaints so complex and profound that the therapist and/or multidisciplinary team can feel a bit overwhelmed. The equivalent situation in an ITU (Intensive Therapy Unit) setting might be the ultimate decision whether or not to continue resuscitation as the perceived loss of ‘quality of life’ justifies the removal of life-sustaining medical intervention. In the clinic we are not dealing with such stark binary decision-making but with the grey-area algorithms associated with patients who are the ‘walking wounded’, complaining of functional problems. Not considered medically as ‘life or death’ these problems still have an impact, however small or large, on ‘quality of life’.

So how do we define this ‘life quality’? Or, indeed, who defines it? Often, the patient in chronic pain, with relationship issues, work pressures, getting older and with no hope of any improvement, is desperate to ‘get a life’. The therapist cannot give it to them but can help to catalyse attitudinal changes. Hope and positive self-belief are powerful healing agents. Set against this, however, is mass consumerism and societal pressures where self-esteem often seems pegged to what the individual is earning or whether they have the latest gadget/ clothes/ car, etc..Is life worth living if you can’t keep up with this?

As advances in medical technology lead to situations when a person’s vital functions can be artificially maintained beyond our conventional idea of life preserved, we will be confronted more often by moral questions of how best to intervene. This is at a time when infant mortality and death rates from killers such as cancer and heart disease have dramatically declined. Life expectancy is expected to continue increasing. As a result, we are now in a situation when qualitative assessment of life is eclipsing the quantitative. Being kept alive (by machines, drug regimes, teams of professionals and over-stretched carers) is not the same as living.

The saying goes: ‘Where there is life there is hope’. Perhaps that now be changed to: ‘Where there is hope there is life.’

The mystic Edgar Cayce predicted that science would one day ‘prove’ God and spirituality ‘by backing into it’. Working with and alongside scientists for 2 decades, I believe that day is imminent, if it hasn’t already happened. I also believe that the heart – the human organ of the heart – is key. Let me explain.

Long before we are born, indeed just shortly after we are conceived, our heart begins beating all on its own. At this time the brain has not yet begun to form so we know it could not be ‘instructing’ the heart to beat – in fact we have no knowledge about how or why the heart begins to beat on its own – it just does. There is a lot more about the heart we don’t know, but there is also a great deal that scientists are finding out, discoveries that are so recent that they have not yet made their way into mainstream consciousness. One such discovery is the power of the heart’s electrical signals.

HEART RATE VARIABILITY

Most people know that the condition of the heart indicates levels of physical fitness. What is not so widely known is that the heart can also reveal our emotional state and our ability to cope under pressure. When we experience stress, or emotions like anxiety, anger or frustration, stress hormones such as cortisol and adrenaline are released into our system, causing, among other things, the heart to beat faster.

The heart rate changes constantly without any physical or mental exertion. There are also minute differences in the time between each heartbeat that vary continuously. These changes in the variety of time between heart-beats are referred to as Heart Rate Variability or HRV, and create a pattern in the heart’s electrical signals. By looking at the changing pattern of these electrical signals we can determine how fit someone is and how well they are able to handle stress and emotional pressure.

HRV is easily measured using an electrocardiogram, or can be also approximately calculated (usually for educational purposes, i.e. as a bio-feedback tool) by measuring the heart’s pulse waves. HRV patterns vary immensely and on-going studies are finding how the dynamics of HRV relate to the various emotional states we experience. What scientist know already, is that the HRV changes according to the emotional experience of the person in question; the HRV pattern becomes more erratic and less coherent, in proportion to the degree of upset, stress or anger a person feels:

The HRV pattern reflects the quality of the electrical signals emitted from the heart which travel to the brain and to every cell in the body, and which may be erratic or coherent depending on our emotional state of being. The electrical signals that travel to the brain, effect it’s functioning. When the variance or HRV is weak, signals from the heart are chaotic and disordered; this means that the messages received by the brain are also chaotic and disordered! The result is that clear, intelligent thinking is inhibited. This is what we experience when we are in a stressful situation and we feel like we can’t think straight! The part of our brain that is responsible for intelligent thinking and higher consciousness begins to, literally, shut down. Conversely, when we are in a state of calm and emotional balance, our heart rate variability pattern reflects this, sending strong, coherent and harmonious signals to the brain. Effectively, this ‘switches on’ the brain, allowing us to operate at a more intelligent and conscious level – a level that, I would dare to suggest – is more needed now than ever before!

On some level, we all know that we function better when we feel good, – that when we feel cheerful we are more likely to behave kindly towards others, have creative ideas, to problem-solve better, and to say clever things. However, now that science has proved it, we can move into the ‘feel good’ state with increased confidence, knowing not just intuitively, but factually that we are actually biologically designed to function best when we feel happy!

Jennifer Day is a coach and facilitator, working with organizations and individuals, specializing in executives and parents. She is available for coaching sessions – offering HRV feedback technology to gage needs and progress – at Calmer Clinics and privately.

This Blog post is an excerpt from BEING WHAT YOU WANT TO SEE by Jennifer Day. Available at all good bookstores, and at Calmer Clinics.